EOB denial code PR-26: what it means

What it means

The service happened before your coverage started, so the plan did not pay for it.

Patient Responsibility — an amount the patient owes, such as a deductible, copay, coinsurance, or non-covered service.

Official X12 description

“Expenses incurred prior to coverage”

Typical cause

The date of service is earlier than your plan's effective date, or coverage had not yet begun.

What to do next

1. 1Verify your coverage effective date against the date of service.
2. 2If your coverage actually started earlier, send proof of the effective date to your insurer.